The Coppit Family Daily News

Dorothy did a single practice push, and the baby’s heart rate went way down. Like from 165 down to 80 or so. It took a lot longer to recover as well. The next three contractions were bad too. The decelerations were still delayed, but the heartrate drop was more significant that before.

I was a bit shocked by this, and it convinced me more than the doctor’s arguments that maybe Dorothy should have the surgery. (In hindsight, I wonder if this is utterly normal, and that they knew that this would convince me.) Dorothy all along wanted what was best for the baby above all else. I did too, but wasn’t willing to opt for potentially dangerous surgery without a good reason.

After the last conversation, I found this paper on the web. Christopher’s heartrate monitor was like Figure 10–the “V” shape plus a delayed deceleration. According to the paper, this is possibly a result of “uterine hyperstimulation”. In other words, I think she got too much pitocin.

In hindsight, I guess we didn’t realize that (1) induction doesn’t always work, and (2) that there might be consequences of too much pitocin. Oh well… In any case, we decided to do the C-Section.

At 7am Dr. Lantkowski went home for her son’s birthday. The new doctor, Dr. McMillan, was not too happy with the heartbeat traces, and strongly urged us to go for the C-section.

What I didn’t appreciate was how she went about it. Instead of arguing the health implications, she basically told Dorothy that we could get the baby out with no pushing. She also said, “The cord is wrapped around his neck.” So the doctor was appealing to Dorothy’s pain and giving us misinformation (or at least unconfirmed information).

I pushed back, saying that she didn’t know if the cord was around the neck, especially since the pH is okay. Besides, the labor is progressing well… There’s not any “moulding” of the baby’s head, indicating that he’s fitting okay. Based on all this, we should at least try some pushing before running to the operating room. The doctor was not happy, but was willing to try.

Dr. Lantkowski has been checking on Dorothy every couple of hours, and she has been progressing. She is now at about 8 cm. However, the heartrate problem is still there.

The doctor presented us with some options:

1. Do nothing, and hope it works out
2. Do a ceasarean section
3. Do a pH test to see if he’s actually struggling for oxygen

We went with the pH test, since it would give us more information for deciding the other two. The doctor did the procedure, which amounted to cleaning off the baby’s head, pricking it, and drawing some blood with a tube. A lab tech brought a portable pH meter that reported Christopher’s pH to be okay. This means that he’s not struggling for oxygen.

The doctor said that she hadn’t done that procedure for 10 years. She was surprised that they could give the results to her right then in the room.

Based on this data, we decided to keep going with the labor.

At around midnight, Dorothy’s epidural started getting too weak for the nurses to be able to manage with higher flow rates. Now she was back to strangling the bed rail. At that point the on-call anesthesiologist came up and gave her the “good stuff”. This knocked out her legs, but also the pain.

Unfortunately, at about that time, Christopher’s heart rate starting acting funny. It would slow down after a contraction, and recover after a while. Apparently this was worrisome to the nurse, who fetched the doctor. In general a slowdown is to be expected, but these were delayed after the contraction. This is possibly caused by the umbilical cord being pinched by the contraction. They tried shifting Dorothy around in order to get the cord “unpinched” but that didn’t help.

The contractions are getting more intense this afternoon. Dorothy keeps trying to sing Yankee Doodle, but it’s hard for her to concentrate on the lyrics. Apparently the La Maze people are right about breathing–it’s all you can concentrate on.

Now that the pain has gotten pretty intense, Dorothy has called for the anesthesiologist. She’s crying in pain, and has just about ripped the railing off her bed. She has also thrown up from the pain a couple times. She regrets having the soup for lunch.

Believe it or not, the anesthesiologist’s name is….. Dr. Hurt.

They poked her back like 6 times trying to get in. Apparently her ligaments are pretty tough. They also called in a second doctor to help with the poking. This guy was able to finally get it in there. One funny thing was that every time she yelped, they would ask her which side she felt the pain on.

At around noon the Foley balloon popped out. This is a sure indication that she’s about 3 cm dilated. Sure enough, the doctor was able to break her water.

Hopefully her body will take over now and get things going. I suspect that tonight will be a long night.

Dorothy’s still at 1 cm this morning, so they’ve decided to “help things along” with a little physical dilation. The tool they’re going to use is a Foley catheter… A balloon they put behind the cervix, along with some tension on the catheter tube.

I guess they hope that her cervix is ready, but just not dilating because it’s “posterior” or somesuch. The pitocin seems to be working pretty well, so hopefully this will do the trick.

All this afternoon we had pitocin running, but Dorothy is still only about half a centimeter dilated. Tonight they are going to try the third Cervadil dose. More movies and ice cream, I guess.

Apparently the night nurse didn’t actually put the pitocin in the saline before the morning shift change, so we wasted the entire morning pumping plain fluids into Dorothy, at increasing rates.

The nurse finally figured out what was going wrong, which would explain why Dorothy is having absolutely no contractions. Now that we have pitocin running, it looks like contractions are starting.

They woke us up early today to start the pitocin… Hopefully this will get the contractions going.

Today was kinda boring. We just waited around while the gel did its thing. Occassionally a nurse would come in and check her cervix, commenting on its detailed status. Apparently its position is pretty “posterior”.

We sat around working (me), reading (her) and watching movies (both). Tonight they will apply another hit of Cervadil.

On the plus side, we get to listen to his heartbeat. Unfortunately, the monitor on her belly keeps losing the signal as she or he shifts around.

We arrived at 7am at the Sentara Williamsburg hospital to start the induction. He’s due on the 19th, but we’re going to induce a few days early.

An ultrasound we did last week suggested that he might be about 9 lbs, and since babies add up to a pound a week at the end, he would be around 10 lbs today. They have a plus or minus 30% on the estimate, but our feeling is that he really is that big.

Apparently Dorothy was told to show up at 7am, but the nurses expected her at 4pm. This wasn’t a problem… They just let us in early.

Today the goal is to prepare the cervix with Cervadil, a gel that softens it so that it will dilate more easily.